Eligibility Verification

Determining the eligibility of a patient’s insurance and benefit coverage is critical, as it directly affects the reimbursement due to you. According to the MGMA 30% of all denials could have been avoided if there had been a proper verification process in place. It is essential to perform the eligibility criteria prior to every patient’s office/hospital appointment. Verification processes are somewhat time-consuming, and most healthcare providers may not have the time or the training required to carry out patient eligibility verification.

RevExp can provide expert assistance with eligibility verification. RevExp provides a full service eligibility solution that eliminates administrative burden. We bring unprecedented verification and collection efficiency to medical front offices with advanced technology combined with proprietary process.

The benefit eligibility data we obtain include details such as:

  • Patient eligibility verification
  • Payable benefits
  • Patient details
  • Co-pays
  • Co-insurance details
  • Pre-authorization number
  • Deductibles
  • Patient policy status
  • Effective date
  • Type of plan and coverage details
  • Plan exclusions
  • Claims mailing address, and more